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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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Year : 2020  |  Volume : 24  |  Issue : 2  |  Page : 395-396
 

Floret-like giant cells in intra-osseous schwannoma


1 Department of Oral Pathology, Yenepoya Dental College, Yenepoya Deemed to be University, Mangalore, Karnataka, India
2 Arogya Multispeciality Dental Clinic, Moodbidri, Mangalore, Karnataka, India

Date of Submission16-Apr-2020
Date of Decision09-Jul-2020
Date of Acceptance21-Jul-2020
Date of Web Publication09-Sep-2020

Correspondence Address:
Sudeendra Prabhu
Department of Oral Pathology, Yenepoya Dental College, Yenepoya University, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jomfp.JOMFP_156_20

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   Abstract 


Floret-like giant cells are very commonly seen in neurofibroma and as an indication to be associated with neurofibromatosis type 1 gene. This particular case of intraosseous schwannoma of mandible showing such giant cells, which is rarely reported.


Keywords: Floret, giant cells, neurofibroma, schwannoma


How to cite this article:
Prabhu S, Athikari R, Jose M, Shetty M. Floret-like giant cells in intra-osseous schwannoma. J Oral Maxillofac Pathol 2020;24:395-6

How to cite this URL:
Prabhu S, Athikari R, Jose M, Shetty M. Floret-like giant cells in intra-osseous schwannoma. J Oral Maxillofac Pathol [serial online] 2020 [cited 2020 Sep 21];24:395-6. Available from: http://www.jomfp.in/text.asp?2020/24/2/395/294608




Schwannoma is a slow-growing benign neoplasm derived from Schwann cells, which are sheath cells that cover myelinated nerve fibers. The soft tissue of the head-and-neck region is one of the most common sites for benign nerve sheath tumors. Intra-osseous occurrence is very rare.[1] This is a case of intraosseous schwannoma [Figure 1] of the mandible, with typical Antoni-A type of histopathological pattern [Figure 2], with floret-like giant cells [Figure 3].
Figure 1: Well-defined radiolucent lesion in the lower left region of mandible

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Figure 2: Spindle cells arranged in a palisading manner around the verocay bodies

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Figure 3: Floret-like giant cells with nuclei arranged in a wreath like manner

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Floret-like giant cells are typical multinucleated cells with nuclei arranged in a wreath like or linear pattern.[2] These are reported to be seen in neurofibromas (sporadic), neurofibromas with neurofibromatosis type 1(NF-1), pleomorphic lipoma, giant cell collagenoma, giant cell fibroblastoma, solitary fibrous tumor and gynecomastia. Immunohistochemically, these cells are positive for vimentin and CD-34 but negative for S-100 and CD68.[3],[4]

It is commonly associated with neurofibroma, that to neurofibroma with NF-1. A retrospective study by Taungjaruwinai and Goldberg et al. found out that the presence of floret-like giant cells in neurofibromas might be a clue to the presence of NF-1.[2] However, the results of a study by Magro et al. showed that there is no statistically significant correlation between the presence of these cells and neurofibromas with NF-1, as many cases of sporadic neurofibroma, also showed similar cells. They concluded that these giant cells most likely representing a morphological reactive change of the indigenous dermal/endoneurial fibroblasts or dendritic cells in response to unknown micro-environmental stimuli.[5]

A thorough search of English language literature showed no case report of schwannoma with floret-like giant cells. Here, the lesion is solitary and intraosseous, which is showing typical features of schwannoma. The patient is not having any features of NF-1.

We wanted to highlight this case report to emphasize the presence of such giant cells in schwannoma (which is not reported earlier), and also to look for the presence of floret-like giant cells in cases of schwannoma retrospectively.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Zainab H, Kale AD, Hallikermath S. Intraosseous schwannoma of the mandible. J Oral Max Pathol. 2012;16:294-6.  Back to cited text no. 1
    
2.
Taungjaruwinai WM, Goldberg LJ. Multinucleate giant cells in neurofibromas: A clue to the diagnosis of neurofibromatosis. J Cutan Pathol 2009;36:1164-7.  Back to cited text no. 2
    
3.
Shaktawat SS, Golka D. Floret-like multinucleated giant cells in neurofibroma. Diagn Pathol 2007;2:47.  Back to cited text no. 3
    
4.
Stanger K, De Kerviler S, Vajtai I, Constantinescu M. The riddle of multinucleated “floret-like” giant cells and their detection in an extensive gluteal neurofibroma: A case report. J Med Case Rep 2013;7:189.  Back to cited text no. 4
    
5.
Magro G, Amico P, Vecchio GM, Caltabiano R, Castaing M, Kacerovska D, et al. Multinucleated floret-like giant cells in sporadic and NF1-associated neurofibromas: A clinicopathologic study of 94 cases. Virchows Arch 2010;456:71-6.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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